372 FCETAL DYSTOKIA. 



BOOK 11. 



FCETAL DYSTOKIA. 



Though the obstacles to parturition offered by the maternal organs are 

 somewhat considerable in number, yet it is found in practice that those 

 due to the foetus are far more frequently met with, and are much more 

 numerous ; though all of them may not constitute real or serious 

 obstacles, some being easily removed or overcome, when birth takes 

 place without any difficulty. 



The obstacles which the foetus may offer to birth are, for convenience 

 of study, divided into two natural groups, according as they result from 

 some physical condition of the young creature itself, or from the more 

 or less irregular manner in which it is presented at the pelvic inlet. 

 Each of these groups, again, it is needless to add, embraces a certain 

 number of varieties of obstacles ; but though grouped and classified in 

 this way, it must be remembered that difficult parturition due to the 

 foetus may not be owing exclusively to any one of these obstacles in 

 every case, but in some instances may result from a combination of two 

 or more of them 



This combination, however, does not preclude us from studying them 

 separately ; indeed, their separate consideration is absolutely necessary, 

 as it is only by analysing them that we can realize their influence in hin- 

 dering birth, either when alone or combined. 



As will be seen from the following synoptic table, the obstacles in the 

 first group are very numerous and varied, and require careful considera- 

 tion from the obstetrist — opening, as they do, a wide field for investiga- 

 tion and reflection, as well as practical deduction ; and none the less 

 so with those of the second group, to be dealt with hereafter. 



Synoptic Table of Fcetal Dtstokias independent ob' Pbesentations 

 AND Positions. 



( Umbilical Cord. 

 Excess in Volume. 

 Excess in Growth of Hair. 

 Anomalies and Diseases of Membranes. 

 Abnormal Quantity of Placental Fluid. 



'Hydrocephalus. 

 Ascites, Anasarca, and 

 Hydrothorax. 

 Diseases ■^ Emphysema. 

 Polysarcia. 

 Contractions. 

 Tumours. 



Monstrosities. 

 ^Multiparity. 



Dystokia from 



GROUP I. 



OBSTACLES INDEPENDENT OP PKESENTATIONS AND POSITIONS. 



In this group, the maternal organs of generation and those parts imme- 

 diately concerned in parturition may be perfectly healthy, and the foetus 

 itself may be in a favourable position for expulsion ; yet birth is either 

 protracted or rendered impossible without assistance, because of the 

 umbilical cord, the excessive volume of the foetus, excess in growth of 



